## Abstract In a prior study, 10 patients with focal hand dystonia learned braille reading as sensory training for 8 weeks. Practice time was 30 to 60 minutes daily. They improved both their spatial acuity using the Grating Orientation Discrimination Task (GOT) and their dystonia using the Fahn sca
Motor training as treatment in focal hand dystonia
β Scribed by Kirsten E. Zeuner; Holly A. Shill; Young H. Sohn; Fiona M. Molloy; Bonnie C. Thornton; James M. Dambrosia; Mark Hallett
- Publisher
- John Wiley and Sons
- Year
- 2005
- Tongue
- English
- Weight
- 118 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0885-3185
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β¦ Synopsis
Abstract
Focal hand dystonia may arise as a result of aberrant plasticity from excessive repetitive use. Improvement might be possible with appropriate motor training. Focusing on trying to decrease abnormal overflow of movement to fingers not involved in a task, we developed a motor training program for individualized finger movements. Ten patients with writer's cramp participated in the motor training program. Evaluation was done with the Fahn dystonia scale, kinematic analysis of handwriting, transcranial magnetic stimulation (TMS), and electroencephalography (EEG). Clinical improvement of dystonia was significant using the Fahn dystonia scale, and 6 patients reported an improvement in writing. The handwriting analysis showed a trend for improvement after training in simple exercises. There were no changes in cortical excitability measured by TMS and EEG. Whereas this method of motor training for 4 weeks led to mild subjective improvement and some improvement in handwriting, it is not sufficient to reverse motor cortex abnormalities measured by TMS and EEG. Published 2004 John Wiley & Sons
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Botulinum toxin is now the first-line therapy for writer's cramp and other occupational dystonias, with wellestablished efficacy and safety. Future studies will allow us to understand better the physiological effects of injection and to refine and enhance our treatment of focal hand dystonia.
## Abstract Cortical activation is reduced when patients with focal dystonia perform movements that do not induce dystonic posturing. This finding suggests that the cortical drive to muscles may in some circumstances actually be reduced not increased, as suggested by basal ganglia models of dystoni
## Abstract No consistent cerebral anatomical abnormality has ever been reported in primary focal hand dystonia (FHD). The present voxelβbased morphometry study showed a significant bilateral increase in gray matter in the hand representation area of primary somatosensory and, to a lesser extent, p